<template>
  <div>
    <el-row :gutter="15">
      <el-form ref="elForm" :model="formData" :rules="rules" size="medium" label-width="100px">
        <el-col :span="8">
          <el-form-item label="检查时间：" prop="field101">
            <el-date-picker type="datetime" v-model="formData.field101" format="yyyy-MM-dd "
              value-format="yyyy-MM-dd " :style="{width: '100%'}" placeholder="请选择检查时间" clearable>
            </el-date-picker>
          </el-form-item>
        </el-col>
        <el-col :span="8">
          <el-form-item label="检查人：" prop="field102">
            <el-input v-model="formData.field102" clearable :style="{width: '100%'}" placeholder="请输入检查人" clearable></el-input>
          </el-form-item>
        </el-col>
        <el-col :span="8">
          <el-form-item label-width="120px" label="检查机构名称：" prop="field103">
            <el-input v-model="formData.field103" clearable :style="{width: '100%'}" placeholder="请输入检查机构名称" clearable></el-input>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item label-width="91px" label="检查结果:" prop="field104">
            <el-radio-group v-model="formData.field104" size="medium">
              <el-radio v-for="(item, index) in field104Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-radio>
            </el-radio-group>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="左侧颈总内膜增厚" prop="field105">
            <el-input v-model="formData.field105" clearable :style="{width: '100%'}"></el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="右侧颈总内膜增厚" prop="field106">
            <el-input v-model="formData.field106" clearable :style="{width: '100%'}"></el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="119px" label="左侧斑块数量" prop="field107">
            <el-input v-model="formData.field107" clearable :style="{width: '100%'}"></el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="119px" label="右侧斑块数量" prop="field108">
            <el-input v-model="formData.field108" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="左侧颈总斑块形态" prop="field109">
            <el-input v-model="formData.field109" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="右侧颈总斑块形态" prop="field110">
            <el-input v-model="formData.field110" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="左侧窦部斑块形态" prop="field111">
            <el-input v-model="formData.field111" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="右侧窦部斑块形态" prop="field112">
            <el-input v-model="formData.field112" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="左侧颈部斑块形态" prop="field113">
            <el-input v-model="formData.field113" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="145px" label="右侧颈部斑块形态" prop="field114">
            <el-input v-model="formData.field114" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="136px" label="左侧SA斑块形态" prop="field115">
            <el-input v-model="formData.field115" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="135px" label="右侧SA斑块形态" prop="field116">
            <el-input v-model="formData.field116" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="162px" label="左侧椎动脉斑块形态" prop="field117">
            <el-input v-model="formData.field117" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="161px" label="右侧椎动脉斑块形态" prop="field118">
            <el-input v-model="formData.field118" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="150px" label="左侧颈总斑块溃疡" prop="field119">
            <el-input v-model="formData.field119" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="150px" label="右侧颈总斑块溃疡" prop="field120">
            <el-input v-model="formData.field120" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="150px" label="左侧窦部斑块溃疡" prop="field121">
            <el-input v-model="formData.field121" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="150px" label="右侧窦部斑块溃疡" prop="field122">
            <el-input v-model="formData.field122" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="150px" label="左侧颈部斑块溃疡" prop="field123">
            <el-input v-model="formData.field123" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="150px" label="右侧颈部斑块溃疡" prop="field124">
            <el-input v-model="formData.field124" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="143px" label="左侧SA斑块溃疡" prop="field125">
            <el-input v-model="formData.field125" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="140px" label="右侧SA斑块溃疡" prop="field127">
            <el-input v-model="formData.field127" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="169px" label="左侧椎动脉斑块溃疡" prop="field128">
            <el-input v-model="formData.field128" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="169px" label="右侧椎动脉斑块溃疡" prop="field129">
            <el-input v-model="formData.field129" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="157px" label="左侧颈总斑块回声" prop="field130">
            <el-input v-model="formData.field130" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="157px" label="右侧颈总斑块回声" prop="field131">
            <el-input v-model="formData.field131" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="157px" label="左侧窦部斑块回声" prop="field132">
            <el-input v-model="formData.field132" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="157px" label="右侧窦部斑块回声" prop="field133">
            <el-input v-model="formData.field133" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="157px" label="左侧颈部斑块回声" prop="field134">
            <el-input v-model="formData.field134" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="157px" label="右侧颈部斑块回声" prop="field135">
            <el-input v-model="formData.field135" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="148px" label="左侧SA斑块回声" prop="field136">
            <el-input v-model="formData.field136" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="150px" label="右侧SA斑块回声" prop="field138">
            <el-input v-model="formData.field138" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="174px" label="左侧椎动脉斑块回声" prop="field139">
            <el-input v-model="formData.field139" placeholder="  " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="177px" label="右侧椎动脉斑块回声" prop="field140">
            <el-input v-model="formData.field140" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="149px" label="左侧颈总狭窄率" prop="field141">
            <el-input v-model="formData.field141" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="149px" label="右侧颈总狭窄率" prop="field142">
            <el-input v-model="formData.field142" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="149px" label="左侧窦部狭窄率" prop="field143">
            <el-input v-model="formData.field143" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="149px" label="右侧窦部狭窄率" prop="field144">
            <el-input v-model="formData.field144" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="153px" label=" 左侧颈部狭窄率" prop="field145">
            <el-input v-model="formData.field145" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="153px" label="右侧颈部狭窄率" prop="field146">
            <el-input v-model="formData.field146" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="140px" label="左侧SA狭窄率" prop="field147">
            <el-input v-model="formData.field147" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="144px" label="右侧SA狭窄率" prop="field148">
            <el-input v-model="formData.field148" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="164px" label="左侧椎动脉狭窄率" prop="field149">
            <el-input v-model="formData.field149" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="171px" label="左侧椎动脉狭窄率" prop="field150">
            <el-input v-model="formData.field150" placeholder=" " clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item size="large">
            <el-button type="primary" @click="submitForm">提交</el-button>
            <el-button @click="resetForm">重置</el-button>
          </el-form-item>
        </el-col>
      </el-form>
    </el-row>
  </div>
</template>
<script>
export default {
  components: {},
  props: [],
  data() {
    return {
      formData: {
        field101: undefined,
        field102: undefined,
        field103: undefined,
        field104: undefined,
        field105: undefined,
        field106: undefined,
        field107: undefined,
        field108: undefined,
        field109: undefined,
        field110: undefined,
        field111: undefined,
        field112: undefined,
        field113: undefined,
        field114: undefined,
        field115: undefined,
        field116: undefined,
        field117: undefined,
        field118: undefined,
        field119: undefined,
        field120: undefined,
        field121: undefined,
        field122: undefined,
        field123: undefined,
        field124: undefined,
        field125: undefined,
        field127: undefined,
        field128: undefined,
        field129: undefined,
        field130: undefined,
        field131: undefined,
        field132: undefined,
        field133: undefined,
        field134: undefined,
        field135: undefined,
        field136: undefined,
        field138: undefined,
        field139: undefined,
        field140: undefined,
        field141: undefined,
        field142: undefined,
        field143: undefined,
        field144: undefined,
        field145: undefined,
        field146: undefined,
        field147: undefined,
        field148: undefined,
        field149: undefined,
        field150: undefined,
      },
      rules: {
        field101: [{
          required: true,
          message: '请选择时间选择',
          trigger: 'change'
        }],
        field102: [{
          required: true,
          message: '',
          trigger: 'blur'
        }],
        field103: [{
          required: true,
          message: '',
          trigger: 'blur'
        }],
        field104: [{
          required: true,
          message: '检查结果:不能为空',
          trigger: 'change'
        }],
        field105: [{
          required: true,
          message: '',
          trigger: 'blur'
        }],
        field106: [{
          required: true,
          message: '',
          trigger: 'blur'
        }],
        field107: [{
          required: true,
          message: '',
          trigger: 'blur'
        }],
        field108: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field109: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field110: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field111: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field112: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field113: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field114: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field115: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field116: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field117: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field118: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field119: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field120: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field121: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field122: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field123: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field124: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field125: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field127: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field128: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field129: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field130: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field131: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field132: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field133: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field134: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field135: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field136: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field138: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field139: [{
          required: true,
          message: '  ',
          trigger: 'blur'
        }],
        field140: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field141: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field142: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field143: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field144: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field145: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field146: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field147: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field148: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field149: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
        field150: [{
          required: true,
          message: ' ',
          trigger: 'blur'
        }],
      },
      field104Options: [{
        "label": "全部异常",
        "value": 1
      }, {
        "label": "任一部位有异常",
        "value": 2
      }],
    }
  },
  computed: {},
  watch: {},
  created() {},
  mounted() {},
  methods: {
    submitForm() {
      this.$refs['elForm'].validate(valid => {
        if (!valid) return
        // TODO 提交表单
      })
    },
    resetForm() {
      this.$refs['elForm'].resetFields()
    },
  }
}

</script>
<style>
</style>
